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General NPI Number Information
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NPI Number | 1093008799
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Entity Type | Individual
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Provider Name | TERESITA B TADIFA PHARMD
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Gender | Female
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Dates
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Enumeration Date | 05/27/2011
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Last Update Date | 05/27/2011
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Provider Practice Location Address
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Address Line | 12645 S VIRGINIA ST
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City | RENO
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State | NV
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Zip | 89511-4803
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Country | US
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Telephone | 775-853-9887
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Fax |
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Provider Business Mailing Address
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Address Line | 33235 FALCON DR
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City | FREMONT
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State | CA
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Zip | 94555-1128
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Country | US
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Telephone | 510-471-5103
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 18011
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License Number State | NV
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